Lawsuits Involving a “Continuing Pattern of Anticompetitive Behavior” Constitute Related Claims
The United States Court of Appeals for the Eleventh Circuit, applying Florida law, has affirmed a district court’s holding that multiple lawsuits filed against the insured over a fifteen-year period involving a “continuing pattern of anticompetitive behavior” constitute claims “related logically, causally or in any other way.” Health First, Inc. v. Capitol Specialty Ins. Corp., 2018 WL 4025461 (11th Cir. Aug. 22, 2018).
The insured, a regional healthcare company, was sued in a series of lawsuits by the same and different plaintiffs between 1998 and 2013 alleging that it had engaged in various types of anticompetitive behavior. The healthcare company’s insurer accepted coverage for the first two lawsuits under policies issued in 1997 and 1998 and paid out the limits under those policies. The insured later submitted the subsequent lawsuits for coverage. The later insurers concluded that coverage was available only under the 1997 and 1998 policies because, under the policies’ related-claims provisions, related claims constitute a single claim first made when the earliest related claim is made. The later policies defined “Related Claims” as “all Claims for Wrongful Acts based on, arising out of, directly or indirectly resulting from, in consequence of, or in any way involving the same or related facts, circumstances, situations, transactions or events or the same or related series of facts, circumstances, situations, transactions or events, whether related logically, causally or in any other way.”
The Eleventh Circuit affirmed the entry of summary judgement for the insurers that the lawsuits constituted related claims. First, the court rejected the argument that because the insured was seeking indemnification and not invoking the duty to defend, a related-claims determination must be based on the actual facts underlying the legal claims in the lawsuits, not solely on allegations in the complaints. The court concluded that “even though the duty to indemnify depends on the actual facts of the case, there is no rule against relying solely on the complaint to determine whether there is any set of facts that could possibly give rise to coverage” in the first instance and the complaints “revealed . . . no set of facts that could both support the claims in those complaints and be unrelated to the [first two lawsuits].” The court further stated that the insured did not offer “any extrinsic evidence showing that the allegations made in the complaints were actually unrelated.”
Second, the court rejected the argument that the lawsuits were not related considering only the allegations in the complaints. The court held that the “related-claims provisions at issue in this case are extremely broad,” noting that use of the phrase “in any way” suggested that the provisions could “reach conduct with a somewhat attenuated connection.” Despite the different plaintiffs and filing dates, the court continued, the complaints “describe a continuing pattern of anticompetitive behavior” by the healthcare company, including that it “used its monopolistic power to coerce doctors to admit patients exclusively to [its] facilities.”
